Koda Mariusz, Sulkowska Mariola, Kanczuga-Koda Luiza, Tomaszewski Jakub, Kucharczuk Waldemar, Lesniewicz Tomasz, Cymek Slawomir, Sulkowski Stanislaw
Department of General Pathomorphology, Medical University of Bialystok, 15-269 Bialystok, Poland.
Oncol Rep. 2007 Jul;18(1):113-9.
The aim of this study was the analysis of Ki-67, Bcl-2 and Bak expression in primary tumor and axillary lymph node metastases of breast cancer as well as an attempt to assess preoperative chemotherapy influence on the mentioned markers with regard to changes in the morphological appearance of the primary tumor and its metastases. Immunohistochemical examinations of Ki-67, Bcl-2 and Bak expression were conducted on sections collected from 135 patients treated surgically on invasive ductal breast cancer. Sixty-four of these patients were administered preoperative chemotherapy, whilst on 71 patients the surgery was performed without initial chemotherapy. In the group of patients without preoperative chemotherapy positive correlation in Ki-67 and Bcl-2 expression between primary tumors and lymph node metastases (p<0.0001, r=0.707; p<0.0001, r=0.604, respectively) was observed. In the group of patients after chemotherapy positive correlation between primary tumors and lymph node metastases in case of Bcl-2 and Bak proteins (p<0.04, r=0.424; p<0.02, r=0.478, respectively) was observed. It was also found that preoperative chemotherapy has an influence on the expression of proteins connected with proliferation and apoptosis and thus, it can influence neoplastic process biology. It does not have any significant impact on the proapoptotic Bak protein expression either in primary tumor or in lymph node metastases of breast cancer. However, it is related to lower expression of antiapoptotic Bcl-2 protein (p<0.0005) and of Ki-67 proliferation marker (p<0.03) in primary tumors, which indirectly indicates a beneficial influence of preoperative chemotherapy on the primary tumor. Concurrently, the influence of neoadjuvant therapy on lymph node metastases seems to be relatively small, which can limit its effectiveness.
本研究旨在分析乳腺癌原发肿瘤及腋窝淋巴结转移灶中Ki-67、Bcl-2和Bak的表达情况，并试图评估术前化疗对上述标志物的影响，以及其对原发肿瘤及其转移灶形态学外观变化的影响。对135例接受浸润性导管癌手术治疗的患者所取切片进行了Ki-67、Bcl-2和Bak表达的免疫组织化学检查。其中64例患者接受了术前化疗，而71例患者未进行初始化疗即接受了手术。在未接受术前化疗的患者组中，观察到原发肿瘤与淋巴结转移灶中Ki-67和Bcl-2表达呈正相关（分别为p<0.0001，r=0.707；p<0.0001，r=0.604）。在化疗后的患者组中，观察到Bcl-2和Bak蛋白的原发肿瘤与淋巴结转移灶之间呈正相关（分别为p<0.04，r=0.424；p<0.02，r=0.478）。还发现术前化疗对与增殖和凋亡相关的蛋白质表达有影响，因此，它可以影响肿瘤发生过程的生物学特性。它对乳腺癌原发肿瘤或淋巴结转移灶中促凋亡的Bak蛋白表达均无显著影响。然而，它与原发肿瘤中抗凋亡的Bcl-2蛋白表达降低（p<0.0005）和Ki-67增殖标志物表达降低（p<0.03）有关，这间接表明术前化疗对原发肿瘤有有益影响。同时，新辅助治疗对淋巴结转移的影响似乎相对较小，这可能会限制其有效性。
